Lantus And Suicide Case Study

S.P. is admitted to the orthopedic ward. She has fallen at home and she has sustained an intracapsular fracture of the hip at the femoral neck. The following history is obtained from her: She is a 75-year-old widow with three children living nearby. Her father died of cancer at age 62; mother died of heart failure at age 79. Her height is 5’3 and weighs 118 pounds. She has a 50 pack year smoking history and denies alcohol use. She has severe Rheumatoid Arthritis (RA) and had an upper GI bleed in 1993 and had Coronary Artery Disease with CABG 9 months ago. Since that time, she has engaged in “very mild exercise at home.” Vital signs are 128/60, 98, 14, 99 degree farenheight (32.7 degrees C) SAO2 94%

A visit note from Dr. Carico, dated 04/25/2017, indicated that the claimant had scalp area pain, upper back pain, and spares the face. Objective findings showed a blood pressure of 136/84 with a BMI of 44.1. She was referred to neurology.

Shirley Caretaker is a 56 year-old widow who spent the last twenty-five (25) years working in the health care field as a Certified Nurse’s Assistant and Licensed Practical Nurse. Ms. Caretaker’s job-related knee pain was worsened by a work related accident, which also injured her hip and back. She cannot sit or stand for more than 30 minutes at a time, or walk for more than 10 minutes. Pain in her upper back radiates up her neck and through her fingers, which causes her arms and fingers to periodically feel

The nurse will assist Mrs. Thomas in achieving optimal pain control. The nurse will interact with Mrs. Thomas more than any other practitioner. The nurse will have to continuously assess Mrs. Thomas pain control. Due to Mrs. Thomas’s advance stage in her illness her pain control needs will vary depending on her level of conscious and the disease process. Keeping Mrs. Thomas’s level of pain to a level where Mrs. Thomas can still maintain her functional ability will be an ongoing struggle. Too little or too much pain medicine will prevent Mrs. Thomas in participating in activities.

On 5/30/18 I met Mr. Reid at the office of Dr. Rampersaud. I explained that the insurance carrier is not getting the form filled out correctly regarding his narcotic medications. I asked his permission to meet with Dr. Rampersaud when they go back to the examination room and leave once we discussed the form. Mr. Reid agreed. He reports that since having the spinal cord stimulator battery replaced his pain is 60% better. He reports his pain level is a 6. He continues to have his legs give out unexpectable. He reports needing help from his wife to roll him over when he is in bed. He continues to use a wheelchair. Mr. Reid said he wanted to speak with Dr. Rampersaud regarding decreasing his medications at least for the summer. He feels the warm weather makes his pain more tolerable.

Sarah Jennings is a 45 years old female, 5 feet 6inches tall, 130lbs. Today she came in to see Dr. Wallace for 3-month appointment. She has been diagnosed with hypertension, diabetes, and cholesterol. Due her cholesterol medication she was asked to come in to get her liver function checked. During her visit today she mentioned to the doctor she has had knee pain for the past few days. It started after she tripped while hiking last week. Sarah also suffers with bipolar disorder, but she has been doing well with the anti-depressant she is on. She is a very sweet, tiny, determined lady who is trying her best to keep up with all her health issues. She has changed her diet and has been good with exercising daily.

An attending physician statement completed by Dr. Peter Chweyah (Internal Medicine), dated 06/16/2016, indicated that the claimant presented with complaints of lower extremity weakness, neuropathy, weight loss, acute renal failure, and gout, as well as anemia. Objective findings showed an extreme weakness of the legs and pain in the feet. He also had diabetes mellitus type 2, chronic kidney disease, and hypertension. It was noted that the claimant was totally disabled from 05/30/2017 through 06/15/2017 and 05/23/2017 - 05/26/2017 secondary to gout.

The patient is a 72 year old female. She has been experiencing progressively worse pain and stiffness in her joints. She is reports that she is having decreased range of motion, redness, and swelling in her joints. She is reports symptoms occur in the same joints on both sides of her body. She is also reporting the symptoms are worse when she first wakes up in the morning.

The first issue I will address to Mrs. Thomas is how to manage the pain, because the problem really worsens her quality of life, it made her self care difficult to carry out, caused her feeling hopeless, dependent, distressed, fatigue, and losing appetite. Taking pain medications on time will keep the pain

At today's visit he is awake, alert and oriented. He complains of generalized pain. He states “I have pain all over today, my head, my back, my feet" I have not felt good for the last few days”. He rates his pain as 6/10 in severity; he describes his pain as shooting pain in different places. His pain does

Mrs. Cabrera is a 64 years old women with history of high blood pressure, vertigo, and bilateral meniscectomy 3 years ago. Client is currently taking medication on a daily basis for her health conditions. Patient takes pain killer medication at least 3-4 times a week if knee pain is present after ambulating around the home for household activities. Client lives with daughter, grandchildren, and other family members. Patient has a supporting family nucleus, they agreed to make arrangement if necessary to avoid and prevent any potential fall risk.

I met Ms. Milton at Dr. Vanderjadt's office. Her husband was in Canada fishing. Her son brought her to the appointment. Her weight is up from last time, she is using the walker. She reports her legs are very unsteady and will buckle without warning. The braces she got do not stay on, her leg shape is large on the top then down small so they just will not stay up. She said she needs someone standing by her when ever she gets up. Dr. Vanderjadt would like her to go and have custom braces fitted to her leg shape. She was given contact information. She reports her neck is so painful she went to the urgent care clinic. Dr. Vanderjadt reviewed her x-rays and he said her spine is full of age related wear and tear, arthritis. She has had prior back surgery and he said this is all age and nothing they can do about it.

My patient is a 68-year-old Indian male. His health issues include hypertension, Type 2 diabetes, hyperlipidemia, cellulitis, and insomnia. He has been in the facility for 3 years. My patient’s weight is 156 lbs. and there were no major weight changes for the time he has been in the facility. My patient needs assistance with either wheelchair or a walker, is able to ambulate with or without a device. He is not allergic to anything, therefore, no modification to the medication is needed. The primary the patient is in the facility is because of a foot ulcer. The foot ulcer is unable to heal at a normal pace because he has diabetes. My patient did not take any medication prior to admission to the facility.

At today's visit, she is found sitting in her chair. She is awake, alert. She complains of chronic dull, intermittent pain in her right lower extremity with a severity of 4/10. She states that her current pain regimen helps relieve her pain. The staff reports that she her pain regimen seems to manage her pain well. She denies shortness of breath, depression and chest pain.

The writer met with at 25-year-old Caucasian female brought to St John Macomb by her girlfriend and she was transferred to St John Main. The consumer report taking over the several different medications to sleep. The consumer took Tylenol 30 pills, Toprol-XL 25mg, Zoloft 100mg, Risperidone 2 mg, Prazosin 5mg, and Sertraline. The consumer stated she was not trying to commit suicide she just wanted to sleep. the consumer report feeling of hopeless and alone. The consumer lives with her girlfriend and is receiving SSI. The consumer also states she just moved to Michigan about a month ago from New Mexico. The consumer denied any current depression, no auditory/visual hallucination, no suicidal/homicidal ideation, no poor impulse control and